Table 1

Description of ultrasound (US) sites and measurement procedure (see figure 1)

Site nameDescription of the sites
Marking is done in a standing or sitting position, on the right side of the body; see figure 1. All distances (d) are percentages of body height h
Notes on US image capture
All US measurements in a lying position!
Always use a thick layer of US gel (at least 3–5 mm)
UA
Upper abdomen
  1. Mark a vertical line at a distance d=0.02 h (ie, 2% of body height h) lateral to the centre of the umbilicus (omphalion)

  2. Project vertically and mark a horizontal line at d=0.02 h superior to the omphalion (figure 1A). (In case this site is above a tendinous inscription of the rectus abdominis (where subcutaneous adipose tissue (SAT) is thicker), move the probe some mm to the end of this inscription and measure the thickness there)

Lying in a supine position
Have the participant stop breathing at mid-tidal expiration and then capture the image
LA
Lower abdomen
  1. The same line (1) as for the upper abdomen

  2. Project vertically and mark a horizontal line at d=0.02 h inferior to the omphalion. Measure always exactly at this point (figure 1A)

Lying in a supine position
Have the participant stop breathing at mid-tidal expiration and then capture the image
EO
External oblique (optional site)
  1. Locate and mark the anterior superior iliac spine (ASIS).

  2. The participant assists by holding the end of the tape at the apex of the costal arch at the inferior margin of the sternum (where it meets the xiphoid process). The participant looks ahead!

  3. Draw a line from the ASIS in the direction of the costal arch

  4. Mark a perpendicular line at d=0.02 h from ASIS (figure 1A)

Lying in a supine position
Capture the image with the probe held in the direction of the perpendicular line
ES
Erector spinae
  1. Mark a transverse line at d=0.14 h above the solid surface (table) on which the person is sitting in a stretched upper body position with thighs horizontal and legs unsupported

  2. Mark the site at d=0.02 h lateral to the spinous process of the vertebra (figure 1C)

Lying in a prone position
DT
Distal triceps
  1. Put the lower arm on a support surface (table) with the hand in the mid-prone position; mark a vertical line on the most posterior aspect of the arm.

  2. Mark the site on the vertical line at a distance from the surface of d=0.05 h (figure 1D)

Lying in a prone position
Capture the image with the dorsal surface of the hand on the table. Make sure the probe orientation is perpendicular to the skin
BR
Brachioradialis
  1. The participant puts the forearm with the hand in the mid-prone (‘shake-hands’) position on a support table and contracts the brachioradialis (eg, against a resistance provided by the hand of the measurer), figure 1D.

  2. Draw a longitudinal line on the most anterior surface of the brachioradialis muscle

  3. Mark a transverse line at a distance d=0.02 h distally from the anterior surface of the biceps brachii tendon (press the end of the metre rod onto the stretched tendon). Project this line transversely to intersect with the longitudinal line (figure 1D)

Lying in a supine position
Take the image with the arm in a mid-prone position and in contact with the thigh (muscles of the arm are relaxed)
Avoid imaging the vein in case there is one in the vicinity
FT
Front thigh
  1. Put the foot on the anthropometric box which is placed in front of a wall such that the thigh is horizontal and the big toe and the knee touch the wall.

  2. Mark the site at a horizontal distance d=0.14 h from the wall (figure 1E)

Lying in a supine position.
MC
Medial calf
  1. Place the foot on the anthropometric box such that the thigh is horizontal and the leg vertical

  2. Mark the site at d=0.18 h above the surface at the most medial aspect (use a ruler to determine the most medial aspect when looking vertically down (figure 1F)

Lying in a rotated position
Participant rolls onto the right side with the right knee at a 90° angle so that the lateral aspect of the right leg is supported
LT
Lateral thigh
  1. Draw a horizontal line on the lateral side of the thigh at the height of the gluteal fold (at the height of the fold at the most dorsal aspect of the thigh);

  2. Mark the site on this line at the midpoint of the sagittal thigh diameter (figure 1G). Use a calliper for (1) and (2)

Lying in a rotated position
Participant rolls onto the left side with both knees at a 90° angle, with the right leg over the left leg